Appropriate indications for the use of a percutaneous cardiopulmonary support system in cases with cardiogenic shock complicating acute myocardial infarction.
Takeshi Aiba,Hiroshi Nonogi,Tomonori Itoh,Isao Morii,Satoshi Daikoku,Yoichi Goto,Shunichi Miyazaki,Yoshikado Sasako,Takeshi Nakatani +8 more
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TL;DR: Using PCPS in patients with moderate cardiogenic shock may improve their in-hospital survival, but it must be used before the shock becomes severe.
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Abstract: Percutaneous cardiopulmonary support (PCPS) is now available for hemodynamic support in patients with cardiogenic shock, but there are no guidelines for its use. The present study determined the appropriate indications for the use of the PCPS in patients with cardiogenic shock complicating acute myocardial infarction (AMI). Sixty-four consecutive patients with cardiogenic shock complicating AMI had hemodynamic support with an intraaortic balloon pump (IABP; n=38) and/or PCPS (n=26). The shock score (0-15) was calculated immediately before starting these support systems to quantify the severity of shock. Multivariate logistic regression analysis determined the clinical factors affecting in-hospital mortality. The relationship between in-hospital prognosis and the shock score was also examined in the 2 groups. The most significant factor related to the in-hospital prognosis was the shock score (p=0.0007; OR 2.16, 95% CI: 1.37-3.39). Another related factor was revascularization; however, this relationship did not reach statistical significance (p=0.069; OR 0.06). Among the 13 cases whose shock score was 4-8 (moderate shock), 5 survived in the PCPS group, but only 1 of 19 patients survived in the IABP group (p<0.05). None of the patients in either group whose shock score was more than 9 survived. The severity of shock is the most reliable independent predictor of in-hospital mortality in patients with cardiogenic shock complicating AMI. Using PCPS in patients with moderate cardiogenic shock may improve their in-hospital survival, but it must be used before the shock becomes severe.
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JCS 2018 Guideline on Diagnosis and Treatment of Acute Coronary Syndrome.
Kazuo Kimura,Takeshi Kimura,Masaharu Ishihara,Yoshihisa Nakagawa,Koichi Nakao,Katsumi Miyauchi,Tomohiro Sakamoto,Kenichi Tsujita,Nobuhisa Hagiwara,Shunichi Miyazaki,Junya Ako,Hirokuni Arai,Hideki Ishii,Hideki Origuchi,Wataru Shimizu,Hirofumi Takemura,Yoshio Tahara,Yoshihiro Morino,Kenji Iino,Tomonori Itoh,Yoshitaka Iwanaga,Keiji Uchida,Hirohisa Endo,Ken Kongoji,Kenji Sakamoto,Hiroki Shiomi,Takao Shimohama,Atsushi Suzuki,Jun Takahashi,Ichiro Takeuchi,Akihito Tanaka,Toshihiro Tamura,Takahiro Nakashima,Teruo Noguchi,Daisuke Fukamachi,Tomohiro Mizuno,Junichi Yamaguchi,Kenji Yodogawa,Masami Kosuge,Shun Kohsaka,Hideaki Yoshino,Satoshi Yasuda,Hiroaki Shimokawa,Atsushi Hirayama,Takashi Akasaka,Kazuo Haze,Hisao Ogawa,Hiroyuki Tsutsui,Tsutomu Yamazaki +48 more
TL;DR: This document is an English version of JCS 2018 Guideline on Diagnosis and Treatment of Acute Coronary Syndrome reported at the Japanese Circulation Society Joint Working Groups performed in 2018.
Venoarterial ECMO for Adults: JACC Scientific Expert Panel
Maya Guglin,Mark J. Zucker,Vanessa M. Bazan,Biykem Bozkurt,Aly El Banayosy,Jerry D. Estep,John C. Gurley,Karl E. Nelson,Rajasekhar Malyala,Gurusher Panjrath,Joseph B. Zwischenberger,Sean Pinney +11 more
TL;DR: As the use of this technology continues to evolve rapidly, it is important to understand the indications and contraindications; the logistics of ECMO initiation, management, and weaning; the general infrastructure of the program; and ethical considerations, areas of uncertainty, and future directions.
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Percutaneous cardiopulmonary bypass for cardiac emergencies.
TL;DR: The likelihood of patient survival after emergent PCPS is most often related to the patient undergoing a definitive anatomic surgical repair such as coronary artery bypass or pulmonary embolectomy, and conversion to conventional long-term extracorporeal membrane oxygenation or a ventricular assist device is recommended.
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Complications Related to Intra-aortic Balloon Pump in Cardiac Surgery: A Decade Later
Mm M. Elahi,Gk K. Chetty,R. Kirke,Tariq Azeem,R. Hartshorne,Tj J. Spyt +5 more
- 01 Jun 2005
TL;DR: A significant decrease in the IABP-related complications is demonstrated even though complexity of cases referred for surgery has increased and the risk of 1% vascular complications should play little influence on decision-making regarding the use of IABp.
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Percutaneous cardiopulmonary support in pulmonary embolism with cardiac arrest
Katsutaka Hashiba,Jun Okuda,Nobuhiko Maejima,Noriaki Iwahashi,Kengo Tsukahara,Yoshio Tahara,Kiyoshi Hibi,Masami Kosuge,Toshiaki Ebina,Tsutomu Endo,Satoshi Umemura,Kazuo Kimura +11 more
TL;DR: In this small case series, percutaneous cardiopulmonary support (PCPS) had a life saving role in patients with massive PE and cardiac arrest and was also more effective in patientsWith massive PE with cardiac arrest than in Patients with AMI with cardiogenic shock.
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